Promoting Colorectal Cancer Screening in Foreign-Born Chinese-American Women: Does Racial/Ethnic and Language Concordance Matter?
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Chinese Americans are one of the fastest-growing and largest Asian-American subgroups. Approximately 70% of Chinese Americans are immigrants with 46% being of limited English proficiency. Despite colorectal cancer (CRC) being the second leading cause of cancer death in Chinese Americans, Chinese Americans have lower CRC screening rates than other Asian subgroups, and only 40% of CRC cases among Chinese Americans are diagnosed early. Furthermore, CRC is the second most common cancer among Chinese American women. Race/ethnicity concordant providers may process culturally specific knowledge, skills, and experience that may facilitate better communication. Although using an interpreter can help to overcome language barriers between providers and patients, it may not achieve the same level of communication as a language concordant provider. The purpose of this study was to test a community education intervention, taking into account the racial/ethnic and language concordance of the presenter, to increase CRC screening uptake among foreign-born Chinese American women. This study used a quasi-experimental design and a convenience sample of 198 foreign-born Chinese-American women. Logistic regression was used to examine the effect of racial/ethnic and language concordance of the presenter on the return of completed FOBT kits for testing. The Chinese/English-speaking presenter had the highest return rate (73%), followed by the White/English-speaking presenter (61%), and the Chinese/Chinese-speaking presenter (48%), and the differences were statistically significant. Post-education intention to screen was also a significant predictor for returning the FOBT kit for testing. The use of an interpreter did not decrease the effectiveness of the educational intervention.
KeywordsAsian Americans Colorectal cancer screening Racial/ethnic concordance Language concordance Community education
The study was funded by the Institute of Translational Medicine at the University of Chicago Medicine and Research Retirement Foundation. We thank Chinese American Services League for their collaboration, their recruitment of participants, and their assistance with the education sessions. We thank all participants for their time and sharing personal information about their health and well-being.
Compliance with Ethical Standards
Conflict of Interests
Karen Kim, Michael Quinn, and Helen Lam declare that they have no competing interest.
This study was approved by the University of Chicago Institutional Review Board. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all participants for being included in the study.
- 2.Richardson LC, Tai E, Rim SH, et al. Vital signs: colorectal cancer screening, incidence, and mortality – United States, 2002-2010. J Am Med Assoc. 2011;306:701–3.Google Scholar
- 4.US Preventive Services Task Force. Final update summary: colorectal cancer screening, 2015. Retrieved on January 19, 2018 from https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/colorectal-cancer-screening2.
- 7.Humes, KR, Jones NA Ramirez RR. 2010 census briefs: overview of race and Hispanic origin: 2010. U.S. Department of Commerce, Economics and Statistics Administration, 2010.Google Scholar
- 8.Srinivasan S, Guillermo T. Toward improved health: disaggregating Asian American and native Hawaiian/Pacific islander data. Am J Public Health. 2009;90:1731–4.Google Scholar
- 9.Hoeffel EM, Rastogi S, Kim MO, Shahid HT. The Asian population: 2010. U.S. Census Bureau: Washington, DC; 2012.Google Scholar
- 10.U.S. Census Bureau. 2011-2013 American Community Survey 3-year estimates. Retrieved on January 19, 2018 from http://factfinder.census.gov/bkmk/table/1.0/en/ACS/13_3YR/S0201/0100000US/popgroup~016.
- 12.US Centers for Disease Control and Prevention. Cancer screening-United States, 2010. MMWR Morb Mortal Wkly Rep. 2012;61:41–5.Google Scholar
- 16.Ferguson W, Candib LM. Culture, language, and the doctor-patient relationship. Fam Med Community Dent Health. 2002;34:353–60.Google Scholar
- 28.Sabatino SA, Lawrence B, Elder R, Mercer SL, Wilson KM, DeVinney B, et al. Effectiveness of interventions to increase screening for breast, cervical, and colorectal cancers: nine updated systematic reviews for the guide to community preventive services. Am J Prev Med. 2012;43(1):97–118.CrossRefGoogle Scholar
- 29.American Cancer Society. Colorectal cancer facts and figures 2017-2019. Atlanta: American Cancer Society; 2017.Google Scholar